How Do You Solve a Problem Like Malaria?
In this guest article, journalist Olivia Ndubuisi reflects on a malaria podcast she has just published.
While Malaria is one of the most common diseases in Africa, when I set out to produce a podcast on this disease, what I didn’t know was that wherever you are on the African continent you are, Malaria is so common and it’s been accepted as part of life. As something that just happens.
Yet scientists have always worried about malaria. Not just because it kills hundreds of thousands of people each year, not just because pregnant women and children under five are 3 to 5 times more likely to die from the severe kind, they have always worried about the inevitability of resistance.
In The Malaria Podcast, I look at how their worry sparked efforts to defeat this disease: from Chloroquine to mosquito gene editing.
Take Chloroquine for example. It was the first synthetic drug to treat malaria. Formulated in the 1930s by German chemists, they created in a lab the first synthetic version of what would eventually become Chloroquine.
At the time, they thought it was too dangerous for humans but after WW2, in 1947, it was refined, named Chloroquine and became commercially available.
It represented such a revolutionary shift in the life cycle of Malaria treatment. It meant that children, pregnant women and everyone else had access to a first line drug to treat Malaria.
This option proved better than local remedies, it dissolved better, it was absorbed faster in the body and it lasted longer in the bloodstream. Local remedies worked previously, some science was going on because local people knew what tree, harvested at what time, contained quinine, a naturally occurring substance. Quinine proved an essential ingredient in the game changing Chloroquine.
But resistance. Emerged from the Cambodia-Thailand border, between 1957 and 1959.
“What we found at the time is that the level of genetic mutation in the malaria parasite that conferred resistance in the case of Nigeria was almost a hundred percent. Meaning that in many children, under five still building immunity to malaria, the drug wasn’t working” says Christian Happi, a Molecular biologist, one of Time’s 100 Most influential persons of 2025 and an adjunct professor at Harvard’s school of public health.
Scientists like him have for decades surveilled and studied the behavior of mosquitoes to understand the ways they were mutating to resist current interventions to prevent or treat them.
Chloroquine’s replacement, the ACT or the Artemisinin based combination therapy was an improvement. The thinking behind them was if drugs were combined to target multiple parts of the life cycle of the parasite, it would last longer and elongate its effectiveness before any resistance emerged.
Today the WHO has noted that even with those, there is now resistance to the artemisinin part of the combination therapy in certain parts of the world including in Rwanda and Uganda.
Kayode Adeyemi Tolulope, who like Christian Happi has years of research in malaria, says that resistance can only be delayed.
“I just feel like until we look at other ways of eliminating malaria, we would always have this issue. It feels to me like a given. I think our safest bet is to prevent transmission of the malaria parasites at the mosquito population. And that’s why I really enjoy the gene drive approach or the introduction of biologically engineered mosquitoes.”
Scientists in Entebbe working on that technology agree. Entomologist Krystal Birungi and post-doctoral researcher Martin Lukindu are two out of teams making new innovative tools to shore up the resistance prone traditional prevention and treatment means at the Uganda Virus Research Institute.
“The challenge with malaria elimination is the sheer scale of the issue – there are just so many mosquitoes spreading the disease. Gene drive mosquitoes will drastically reduce that number.” Krystal said.
The most important thing Martin wants the work he does in the lab there to lead to is a reduction of the number of infections in his country, Uganda and the amount spent treating it. Success for him is going from the current 15 million cases per year to “less than one million.”
To solve a problem like malaria and to cut down the number of people who die annually, more must be done. In malaria research globally, more is being done but not for long if funding for science keeps disappearing.
Listen to the Episodes Below…
Episode one: (The Past) Chloroquine
Episode two: (The Present) How Do You Solve a Problem Like Malaria?
IMAGE CREDIT: THE CONVERSATION